Clinical Features and Surgical Investigation of Gastrointestinal Stromal Tumor of Rectum_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Bin , XIAO Yi , LIN Guole , NIU Beizhan , QIU Huizhong

Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China;

Corresponding author：

Keywords：

Rectal neoplasm; Stromal tumor; Diagnosis; Treatment

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Objective To investigate the surgical treatment effect for patients with gastrointestinal stromal tumor (GIST) of the rectum and its clinical characteristics.
Methods The medical records of 22 patients who had undergone surgery for GIST of the rectum between March 2003 and February 2010 in this hospital were analyzed.
Results There were 14 males and 8 females with a median age of 51 years (range 27－81 years). There were 12 patients without symptoms, 10 patients with clinical symptoms, included: hematochezia 4 cases, difficult defecation 2 cases, shape of defecate change 2 cases, crissum pain 1 case, times of defecate increase 1 case. Course of disease was 2 weeks-18 months with average 6 months. All patients underwent curative resection: in form of abdominoperineal resection in 3 patients, transanal excision in 8 patients, Mason operation in 8 patients, and transanal endoscopic microsurgery in 3 patients. The median tumor size was 3.1 cm (range 0.4－18.5 cm). The diameter of tumor lt;2.0 cm was 11 cases, 2.1-5.0 cm was 8 cases, 5.1-10.0 cm was 2 cases, gt;10.0 cm was 1 case. Twentyone of 22 cases were positive for CD117, 18 cases positive for CD34, 5 cases positive for αsmooth muscle actin (SMA), and 2 cases positive for Desmin. Local recurrence or hepatic metastasis developed in 2 patients with average 26 months of follow-up (range 1 month to 7 years), and who were then treated with imatinib for more than 1 year.
Conclusions The primarily treatment of rectal GIST is surgical. Imatinib therapy is effective against local and systemic recurrent GIST of the rectum.

Citation： WU Bin,XIAO Yi,LIN Guole,NIU Beizhan,QIU Huizhong. Clinical Features and Surgical Investigation of Gastrointestinal Stromal Tumor of Rectum. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(9): 936-938. doi: Copy

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1. Rubin BP. Gastrointestinal stromal tumours: an update [J]. Histopathology, 2006; 48(1): 8396.
2. Qiu HZ, Lin GL, Xiao Y, et al. The use of posterior transsphincteric approach in surgery of the rectum: a Chinese 16year experience [J]. World J Surg, 2008; 32(8): 17761782.
3. Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor [J]. Hum Pathol, 2008; 39(10): 14111419.
4. Mazur MT, Clark HB. Gastric stromal tumors. Reappraisal of histogenesis [J]. Am J Surg Pathol, 1983; 7(6): 507519.
5. Hirota S, Isozaki K, Moriyama Y, et al. Gainoffunction mutations of ckit in human gastrointestinal stromal tumors [J]. Science, 1998; 279(5350): 577580.
6. Baik SH, Kim NK, Lee CH, et al. Gastrointestinal stromal tumor of the rectum: an analysis of seven cases [J]. Surg Today, 2007; 37(6): 455459.
7. 万远廉, 汤坚强, 柳萍, 等. 直肠间质瘤16例临床病理分析 [J]. 中华外科杂志, 2004; 42(15): 897900. 　.
8. 陈利生, 何纯刚, 梁君林. 直肠间质瘤18例临床分析 [J]. 中华胃肠外科杂志, 2007; 10(4): 387388.
9. 彭卫军, 蒋朝霞, 师英强, 等. CT和MRI对直肠间质瘤的诊断价值 [J]. 中国实用外科杂志, 2006; 26(8): 610612.
10. Hassan I, You YN, Dozois EJ, et al. Clinical, pathologic, and immunohistochemical characteristics of gastrointestinal stromal tumors of the colon and rectum: implications for surgical management and adjuvant therapies [J]. Dis Colon Rectum, 2006; 49(5): 609615.
11. Hou YY, Zhou Y, Lu SH, et al. Imatinib mesylate neoadjuvant treatment for rectal malignant gastrointestinal stromal tumor [J]. World J Gastroenterol, 2009; 15(15): 19101913.
12. Hueman MT, Schulick RD. Management of gastrointestinal stromal tumors [J]. Surg Clin North Am， 2008； 88(3): 599614.
13. Blanke CD, Rankin C, Demetri GD, et al. Phase Ⅲ randomized, intergroup trial assessing imatinib mesylate at two dose levels in patients with unresectable or metastatic gastrointestinal stromal tumors expressing the kit receptor tyrosine kinase: S0033 [J]. J Clin Oncol, 2008; 26(4): 626632.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Features and Surgical Investigation of Gastrointestinal Stromal Tumor of Rectum

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